HIV

All posts tagged HIV

In Africa, where HIV cases are very numerous and for years the contagion takes its toll without stopping, years ago a study among subjects circumcised and uncircumcised pointed out that circumcision led to a lower risk of infection.
The news went around the world and since then many doctors of any nationality, without posing the question, sided in favor of circumcision recommending it to all, as a method of HIV prevention and other urinary infections. Among them, the American Academy of pediatric that from long recommends all families the circumcision for all males newborn.
Fortunately, a lot of pediatricians and urologists, as Italians, have a different view and practice circumcision for therapeutic purposes only and exclusively for the correction of Phimosis, a common children pathology characterized by an abnormal narrowing of the foreskin, and only as a last-resort when the conventional medical therapies are not successful.
I say “fortunately” and there’ll explain why.
Apart from the fact that not all of us live in Africa or in countries where HIV is so widespread, to defend themselves effectively by this disease, there are also other better methods. Most HIV infections in Africa are transmitted by contaminated injections and surgical procedures. In the studies, the effects of other variables that would influence HIV infection were not considered, and critical data were omitted. For example, the HIV status of the female partners of the men was not determined. It was not known which infections were heterosexually transmitted, the effect of circumcision on the rate of heterosexually transmitted HIV could not actually be determined. There are at least 17 observational studies that have not found any benefit from male circumcision in reducing HIV transmission. Among developed countries, the United States has the highest circumcision rate and the highest rate of heterosexually transmitted HIV. Other countries have lower rates of HIV infection than the United States and do not practice circumcision.
In addition, we must consider that the Postectomia surgery is not without risks, and although the incidence is low (0.1 to 35%) there may be complications such as pain, difficulty urinating, local edema, bleeding, flaws, fistula and complications to the penis.

Beyond HIV, circumcision was already widespread in some countries for religious reasons, but this is another story also questionable.
Our Lord has created us as we are and there was no reason to include some organ that was a simple plus. From an evolutionary and physician perspective, every organ in the human body has its specific task and nothing is to be considered as superfluous, beyond what the different cultures and religions suggest or require.
Therefore, the foreskin of the penis was not put there by accident and has its own importance.
One of the major side effects that many circumcised people complain, it is the reduction of overall sensitivity, due to the loss of erogenous tissue. There is a less manageability of the penis, masturbation difficulties, numbness of the glans (which remaining exposed, it is no longer protected from rubbing on clothing), and of the frenulum (for many the most important for the purposes of pleasure), resulting in difficulty orgasmic. Refractory periods (recovery time) become longer and it’s necessary a stronger stimulation of the tissues, which “stressed” can make painful and frustrating the sexual intercourse and masturbation.

In all countries where circumcision is uncommon (like Europe, Argentina, Belize, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Ecuador, Jamaica, Paraguay, Peru, Uruguay and Venezuela), there was not an increase of HIV cases that can be attributed to lack of circumcision. American researchers tend to avoid studying or acknowledging the sexual and psychological harm associated with circumcision. This pro-circumcision bias in American medicine reflects the pro-circumcision bias in American culture. The United States is the only country in the world that in most cases circumcises some of its male infants for non-religious reasons.

Here are ten compelling arguments against circumcision:

Argument #1
The foreskin is natural, necessary and important.
Far from an unnecessary extra flap of skin, the foreskin is actually a highly sensitive and functional organ that serves several important purposes. First, the glans or head of the penis is meant to be an internal organ and the foreskin covers and protects it from harm in much the same way as the eyelid protects the eye. In circumcised males, the glans becomes hardened or keratinized by constant exposure and irritation, which reduces sensitivity. The foreskin itself is a highly sensitive erogenous zone and has more nerve receptors and a greater variety of nerve receptors than any other part of the penis.

Argument #2
Most medical experts do not recommend neonatal circumcision.
There is no medical justification for routine infant circumcision. The purported correlations between an intact foreskin and various diseases and problems that circumcisers have used for years to convince parents to let them cut their newborns have been gradually disproved or shown to be insignificant.
A detailed breakdown of the connections— or lack thereof—between circumcision and conditions such as penile and prostate cancer, urinary tract infections, sexually transmitted diseases including HIV/AIDS, phimosis, balanitis xerotica obliterans (BXO) and even cervical cancer in female partners, is beyond the scope of this article, but parents should be aware that the American Academy of Pediatrics states that, “The existing scientific evidence is not sufficient to recommend routine circumcision,” and the Canadian Paediatric Society confirmed their stance in 1996 that, “Circumcision of newborns should not be routinely performed.”

Argument #3
The penis is naturally self-cleaning and proper hygiene is easy to teach and perform.
The foreskin protects the glans from contaminants and debris. An intact foreskin can also produce a natural moisturizing substance with antibacterial and antiviral properties called smegma, which helps keep the glans soft and the penis clean and healthy. When a baby boy is born, the foreskin is actually attached to the glans to shelter the developing glans from harm. Some doctors still suggest that parents should forcibly retract a baby’s foreskin in order to clean it, but there is no need to do so. The foreskin will naturally detach from the glans as the boy ages and eventually he’ll be able to retract it. Pulling back the foreskin in the shower or bath and rinsing it with warm water is all the cleaning an adult requires in this area. Surgical alteration is hardly necessary to keep the penis clean when warm water and soap are readily available.

Argument #4
Circumcision affects sexual function and desensitizes the penis.
Removing a highly sensitive organ like the foreskin will logically reduce sensation in the genital area. In fact, this point was touted in Victorian times as a benefit of the operation. Masturbation was then thought of as a grave sin and a serious health risk, to blame for nearly all diseases. Since circumcised boys would receive less pleasure from sexual stimulation, they would be less likely to engage in the evil of masturbation.
The foreskin facilitates sexual intercourse by allowing the penis to move in and out of the vagina in its own double-layered sheath of movable skin. Circumcised males lack the self- lubricating properties of the foreskin, which creates friction during intercourse that can result in small tears and bleeding in both the man and woman. Artificial lubricants have been developed largely to make up for the function of the foreskin in circumcised men. The long-term effects of these chemical lubricants are not known.

Argument #5
He doesn’t need to be cut to fit in.
Much has been made of the idea that an uncircumcised boy in our modern society could find himself ridiculed by other circumcised boys in locker rooms, causing serious psychological damage. Boys will find any excuse to make fun of each other and if it’s not the appearance of his penis, it will be something else. Providing a child with a combination of education, honesty and confidence is the best defense against this sort of teasing.
The rate of infant circumcision has been falling steadily since the 1980s, so an uncircumcised boy today may actually find himself in the majority. In 1996, the rate of circumcision in Canada was between three and six percent, falling from a high of 46 percent.
Another pro-cutting argument is the desire of the circumcised father to have his son look the same as him, but this is not so much for the benefit of the son as it is for the father. A boy will be capable of understanding the difference and the reason for it and may someday even thank his parents for giving him the choice his father never had.

Argument #6
Circumcision is painful and traumatic for babies.
Many circumcisers try to convince parents that babies are incapable of experiencing pain and even if they do feel it, they won’t remember it. In fact, scientific evidence proves that babies do feel pain and may feel it even more acutely than adults. Yet most circumcisions are performed without general anaesthesia, which is dangerous for children, and frequently without local anaesthesia in the form of shots or creams that cannot completely eliminate the pain anyway. The pain of circumcision can have serious repercussions on the body of a newborn baby. Babies are known to scream hysterically, stop breathing, lose consciousness, vomit and defecate during the operation. The shock of the surgery can even cause ruptures of the heart, lungs and stomach.
The effects of this trauma can continue after the surgery is completed. Some babies experience severely disrupted sleep patterns, breastfeeding complications and interruptions of the infant- mother attachment process after circumcision.

Argument #7
There are serious potential complications to circumcision.
The rates of complications and accidents related to circumcision is nearly impossible to determine since hospitals are not required to report these incidents, but it is estimated to range from two to 10 percent, while at least one out of every 500 circumcisions results in a serious surgical accident.
The risks of circumcision include bleeding, infection, necrosis (the penis dies and falls off), gangrene, BXO, urinary tract infection, urinary retention, meatal ulceration or stenosis (the urinary opening is damaged, scarred or contracted), urethral fistula (an abnormal tube-like passage in the urethra), hypospadias or epispadias (when the urinary opening appears along the top or bottom of the penis rather than at the tip of the glans) and lymphedema (a swelling of the skin caused by a build-up of lymph fluid).
Botched circumcisions can result in buried penis (the penis retreats inside the body), adhesions, excessive skin loss, curvature of the penis, cysts, skin tags, pitting of the glans, scarring, impotence, amputation of the glans or the entire penis and even death.

Argument #8
We don’t mutilate the genitals of our baby girls.
Female genital mutilation (FGM) is practiced in many cultures around the world. The World Health Organization estimates that as many as two million girls each year are subjected to some sort of genital cutting, which may include amputation of the clitoris, the hood of the clitoris and/or the labia, as well as stitching closed the vaginal opening afterward. Three quarters of these cases occur in the countries of Egypt, Ethiopia, Kenya, Nigeria, Somalia and Sudan.
This kind of genital surgery is seen in the West as barbaric, tribal and torturous. Since the 1990s when FGM was first revealed to the North American public at large, major efforts have gone into eradicating the practice around the world. Yet we still expose our boys to similarly painful, traumatic and unnecessary surgery in North America as a matter of course.

Argument #9
I do not believe that those who have sex (hetero-or homo-) with a stranger they feel protected just because are circumcised, and should always use a condom. A nonsense. Condoms are better than 99% effective and if circumcision results in lower condom use, the rate of HIV infections will increase.

Argument #10
Religious tradition is a poor excuse to subject your baby to circumcision. The history of circumcision is a long and complicated one. As a symbolic ritual it appeared independently in many different ancient cultures around the world. It has been imbued with a variety of meanings—identifying a priestly class, indicating privilege, initiating boys into manhood and representing a commitment to God.

To conclude, I think that as in all the important choices (sexuality, religion, lifestyle, study, work, career) parents ought not take these decisions on their own and make choices that might not be shared by their children when they become adults, especially for those that are irreversible, such as circumcision.

It’s interesting to read the survey carried out by 11 scientific observers, funded by the giant German pharmaceutical Bayer, about the use of condoms by young people in many parts of the world, whose results were released in occasion of the ‘World Contraception Day (WCD)’, a campaign to improve prevention and contraception knowledge. The survey involved 6000 young people from 29 countries in Asia, Europe, Africa, Latin America and United States, with over 600 people in Egypt, and conducted between April and May of this year. They were people between 15 and 24, although some interviewee till 30 in Egypt.

Jennifer Woodside of the “International Planned Parenthood Federation (IPPF),” says: “The results highlight that too many young people do not have a good knowledge about sex, are not encouraged to ask about contraception and have not received the right information on contraceptive to use to protect themselves from unwanted pregnancies or from sexually transmitted diseases. In addition, young people tell us that they do not receive adequate sex education or receiving incorrect information about sex and sexuality, while some urban myth is still taken into consideration.”

Worldwide, approximately 41% of the 208 million of pregnancies that occur each year are unintended. In addition, each year 20% of teenager is victim of a bacterial infection through sexual contact and the age which these infections occur is decreasing. The English Agency ‘Health Protection’ states that the reported cases of sexually transmitted infections have increased from 12,000 to 482,700 in 2009 and two thirds of them are girls between 15-24. The statistics show that over 40% of young people in Australia, Chile, Colombia, Great Britain, Indonesia, Lithuania, Mexico, Poland, Singapore, Sweden and Turkey have already had unprotected sex, and the percentage rises to over 50% in China, Estonia, Kenya, Korea, Norway and Thailand.

Since 2009, the number of people who have had unprotected sex increased by 19% in Great Britain, with forty-three per cent of sexually active aged 16 to 19 admitting to use no contraception, compared with 36 percent of last year. More than half of polled European (55%) say to receive sex education at school, although 14% of young people in Britain say they have had cases of teachers whose information was inaccurate or untrue. The study also points out that in Europe, Asia, Latin America and United States, the most common reason for not using contraception is a lack of preparation, and up to one third of young people in these countries say they did not have any form of contraception available at the time of intercourse.

The statistics are staggering: about 50% of adolescents under the age of 17 in Latin America and Caribbean are sexually active and the percentage rises significantly in every country if it refers to the ‘heavy petting’, erotic activities that do not involve complete sexual intercourse. The sex and eroticism become quite detached from love, a material need, sharing it by the partners, no longer relegated to the simple and solitary masturbation. All over the world, sex images and porno video have become the norm rather than the exception nowadays, thanks to media and web.

Nearly 40 percent of pregnancies worldwide are unplanned and it is estimated that 22% of them ending in abortion. Experts attribute this increase in unprotected sex to the fact that youngs feel embarrassed to talk about sex with family members or doctors and to the lack of adequate sex education in schools. Ignorance and misinformation about sex lead to consider valid myths even, such as taking a shower to prevent pregnancy after sex or the use of fizz beverages for vaginal washing after the intercourse. Even the immoderate use of alcohol leads adolescents to forget the use of prevention.

15% of people in Asia and 14% in Europe affirm to dislike condom or that their partner prefers not to use it. In Italy the number of people saying to – not like – contraception has increased from 3% in 2010 to 24% today. As many as 23% of young people in Uganda and 13% in Slovenia say they had sex without contraception to avoid to appear bumbling. 32% in India say that there is no reason to use it. In Europe, Latin America and United States about half of the surveyed say they were well informed about contraception (46%, 53% and 53% respectively), but the percentage decreases significantly in African and Asian countries.

According to the study, the percentage of girls who affirm to have had a friend or family member with unplanned pregnancy is increased from 36% in 2009 to 55% this year. Only 55% of girls consider themselves well informed on all contraceptive methods available compared to 62% of boys. 16% of boys and girls consider the “coitus interruptus” (the extraction of the penis just before the ejaculation) an effective form of contraception, with the majority of Egyptian people.

About 85 out of 100 sexually active girls in fertile age, not using any contraceptive method, will be pregnant within a year. In Europe, more than a quarter of women aged 15 to 24 years will not use contraception the first time they will have a sexual intercourse.

In Europe, with the exception of France and Italy, more than half of young people say to use Internet to get information on contraception, while almost half of young polled in Africa and Europe seems to make recourse to ‘withdraw’ method, which unfortunately is not a secure method.

Not everyone knows that today there are various ways of contraception available for men and women. These include condoms (male and female), the pill, the intrauterine contraceptive device (Copper or medicated), the releasing intrauterine system (Mirena), the vaginal ring or vaginal sponge, diaphragm and subcutaneous implants (Norplant ), oral contraceptives, the morning-after pill, and sterilization (tubal ligation and vasectomy).

U.S.
In 25 states there are educational programs on sex education where they teach abstinence. Some person believes that AIDS is transmitted by the sweat and that some woman could remain sterile after an abortion.

UK
15% do not use contraceptives because they are too drunk when they have sex.

FRANCE
Once home of sex education at school, in the last three years had a boom of relationships at risk: increased by 111%.

ITALY
Only 31% do not take precautions: half of them are afraid of being discovered by parents, others simply “do not like condoms.”

RUSSIA
The country where sex starts early: 80% of sexually active adolescents between 13-19.

CHINA
Record of unprotected casual sex: the first unprotected intercourse for 58% of teenagers.

SINGAPORE
Being upside down for two hours or by an intimate lavender-based Coca-Cola, are the ways which 6% of girls consider useful for preventing pregnancy.

THAILAND
Having sex during menstruation is the best time for 25% of boys.

INDIA
40% do not use contraception and it’s too embarrassing to ask for condom at the pharmacy.

TURKEY
World Capital of coitus interruptus: used by 52% of interviewed.